NPI | 1053502260 |
---|---|
Entity Type | Individual |
Gender | Female |
Sole Proprietor ? | No |
Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: KY 3005266) |
Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KY 5266P) |
Enumeration Date | 2007-08-05 |
Last Update Date | 2024-02-22 |